| NPI | 1295222503 |
|---|---|
| Doing Business As | PH ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | KRISTI LAWRENCE Director Provider Enrollment 864-797-6118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-02-22 |